Frequently Asked Questions
- When is it time to move your loved one to a care facility?
- Paying for Care
- What are continuing care retirement communities?
- What is independent living?
- What is assisted living?
- How deos an assisted living facility differ from a nursing home?
- What is a nursing home?
- Nursing home services
A family is often faced with the difficult decision of when it is the right time to move a loved one to a Care facility such as an assisted living or skilled nursing facility. Each family situation is very different and it may help you to answer some of the following questions when considering this decision.
- Can your loved one move about safely in home including negotiating stairs, geting in and out of bathroom and narrow doorways?
- Have frequent falls become a problem recently and if so is she/he willing and able to use an assistive device such as walker or quad cane?
- Does your loved one have and use necessary safety equipment such as raised toilet frames, bath tub seats, and personal emergency devices?
- Have any accidents occurred recently with appliances in the home such as the stove or forgetting to turn it off properly?
- If loved one smokes, has she/he had any accidents such as burn holes in clothing or bedding?
- In the event of a fire, do you feel your loved one would follow appropriate emergency measures including calling 911 and leaving premises?
- Is your loved one bathing regularly and able to maintain adequate hygiene including grooming such as hair washing, shaving and oral care?
- Is your loved one changing clothes daily or has he/she developed the habit of wearing the same dirty ones over and over again?
- Has your loved one become progressively dependent with ADLs recently? (Eating, Bathing, Dressing)
- Does your loved one allow outside help when needed to come in and help with personal care, housekeeping chores, and meals?
- Has he/she become easily threatened or suspicious of others, taking medications, or eating certain foods?
- Is your loved one eating properly, suffered recent weight loss, dehydration or simply refusing to eat become a problem?
- Is your loved one taking medications on schedule, following correct dosages, and willing to use an organizer/reminder device if necessary?
- Has your loved one gotten lost or unable to remember personal information such as address, phone number, contacts that enable them to return home?
- Are your caregiver duties causing you to be sleep deprived, miss a lot of work, or be unable to manage other household responsibilities?
- As a primary caregiver, is your health at risk or neglect of other family matters causing serious problems.
- Answering yes to some of these questions does not necessarily mean that your loved one must be relocated to a care facility. However if you determine that many of your answers are yes, then it is possible that having your loved one remain at home is no longer a viable option.
Most of us do not consider how we will pay for nursing home or assisted living care until that need arises. The following information is intended to help you understand what assistance is available for you. If you would rather speak with someone about payor sources, please contact Sherrie Morris, to determine which long term care benefit your loved one will qualify for. Here are some options.
MEDICARE benefits are available to millions of Americans, including those over age 65 and some people under 65 who are disabled. To qualify for Medicare, you must have a Medicare card that reads “hospital insurance” and must have spent a minimum of three consecutive days (not counting the day of discharge) in a hospital. The hospital stay must not have occurred more that 30 days prior to entering the nursing home. Further, a physician must certify that you need skilled nursing care on a continuing basis, and need for skilled nursing care must relate to the reason for hospitalization.
- Medicare Part A - For any eligible resident needing skilled nursing care, Medicare Part A coverage will pay for a semi-private room, meals, nursing services, rehabilitation services, medications, supplies and durable medical equipment for up to 100 days. For the first 20 days in a nursing home, Medicare covers 100 percent of skilled care. From day 21 through day 100, the resident must pay a daily co-insurance rate.
- Medicare Part B - Residents who are eligible for the services covered under Medicare Part B will be responsible for an annual deductible plus 20 percent of the total charges for services such as occupational therapy, physical therapy and speech therapy, as well as medical supplies.
MEDICAID is a state and federal program that will pay most nursing home costs for people with limited means. Eligibility requirements vary from state to state, but this is an option for eligible low-income residents in need of long-term nursing care. If you and your family have limited income and assets, you may qualify for assistance from Medicaid, and we can help you determine your eligibility.
Long -Term Care Insurance is now available through many insurance companies and employers. For more information, visit the National Association of Insurance Commissioners’ web site.
- Medicare www.cms.hhs.gov/medicare/
- Medicaid www.cms.hhs.gov/medicaid/
- National Association of Insurance Commissioners www.naic.org/
The combination of Skilled Nursing care, Assisted Living and Independent Living on one campus is known as a continuing care retirement community. The resident can take advantage of the full range of services available and the ease of transfer to a different type of facility as his or her condition and needs change without needing to look for a new facility, relocate, or adapt to a new setting. For example, the resident may begin in the independent living residences, move to assisted living as he or she needs help with activities of daily living, and eventually move to the nursing home as ongoing care becomes necessary.
Independent living is for people who want to and are able to live independently but do not want to maintain a home. Many people prefer to live in a community with others of the same age and with similar interests. An independent retirement community allows for a great deal of social activities and trips.
Assisted living facilities are for people needing assistance with Activities of Daily Living (ADL’s) but wishing to live as independently as possible for as long as possible. Assisted living exists to bridge the gap between independent living and nursing homes. Residents in assisted living centers are not able to live by themselves but do not require constant care either. Assisted living facilities offer help with ADLs such as eating, bathing, dressing, laundry, housekeeping, and assistance with medications. Assisted living is not an alternative to a nursing home, but and intermediate level of long-term care appropriate for many seniors.
Nursing homes are designed to care for very frail people that are not able to care for themselves and have numerous health care requirements. Assisted living facilities are designed to assist elderly persons who are able to care for themselves except for a few activities. Assisted living facilities are often deemed necessary when the person in question needs help preparing meals, bathing dressing, performing household chores, is sometimes confused, or is experiencing memory problems.
A nursing home is an entity that provides skilled nursing care and rehabilitation services to people with illnesses, injuries or functional disabilities. Most facilities serve the elderly. However, some facilities provide services to younger individuals with special needs.
The level of care provided by nursing homes has increased significantly over the past decade. Many homes now provide much of the nursing care that was previously provided in a hospital setting. As a result, most nursing homes now focus their attention on rehabilitation, so that their clients can return to their own homes as soon as possible. Some of the services a nursing home may provide include:
- Therapies (Inpatient and Outpatient)
- Pharmacy Services
- Specialty Care such as: Alzheimer’s treatment, Cancer, Cardiovascular disease, developmentally disabled, Dementia, Mental disease, Neurological diseases, Orthopedic rehabilitation, pain therapy, Pulmonary disease, Stroke, Wound care, etc.